The Kaiser Family Foundation and the Health Research & Educational Trust conducts an annual survey of employer-sponsored health insurance, which covers about 149 million people.  The survey conducted in January through May of 2013 was the 15th of its kind, and included responses from over 2,000 public and private employers with 3 or more employees. The survey found many of the prior year’s trends continuing into 2013: Offer Rates. 57% of all employers offer health benefits to their employees (61% in 2012), but the likelihood of offering benefits varies widely by company size.  45% of small employers with 3-9 workers offer coverage, but almost all employers with 1,000 or more employees offer coverage to at least some of their employees. Premiums and Contributions. Average annual premiums were $5,884 for single coverage (5% increase over 2012) and $16,351 for family coverage (4% increase).  These both mark a major departure from the double digit trend rates that plagued the industry much of the last decade. The amount that employees contribute toward single coverage has nearly doubled in the last ten years, and the amount they contribute toward family premium is not far behind, up 89% over the same period.  In 2013 employers contributed an average of 82% toward single coverage and 71% toward family coverage, relatively unchanged from 10 years ago.  The cost distribution between employers and employees varies depending on company size, type of plan, and other factors. Plan Types. PPOs are the most common type of plan, covering 57% of workers (especially in the larger employers), HDHPs cover 20%, HMOs cover 14%, and POS plans cover 9%.  Enrollment in HDHPs (the newest type of plan) had increased significantly between 2009 and 2011, but the rate of increase has leveled off in 2012 and 2013. The vast majority of employers (87%) only offer one type of plan. Cost Sharing. 81% of workers have plans that include copays for basic services, as well as an annual deductible and coinsurance to meet for more major services.  The average single deductible amount reported was $1,135, however deductible amounts were generally lower in larger companies and higher in smaller companies.  Average copay amounts are $23 for Primary Care Physicians and $35 for Specialists.  Average prescription copays for a 4-tier plan are $10, $29, $52, and $80. Wellness. Employers of all sizes continue to recognize the value of company wellness programs.  Almost all employers surveyed reported offering at least one type of wellness program to employees, including EAP programs, a wellness newsletter, weight-loss and smoking cessation programs, gym membership discounts or reimbursements, and classes and web-based resources for healthy living.  More details:

• 24% of employers offering health benefits provide employees with the opportunity to complete a Health Risk Assessment to help identify areas of concern in the employer population.
• Large companies are more likely to ask employees to complete HRAs, and 54% of large firms offering an HRA provide a financial incentive to complete it.
• 55% of large employers and 26% of smaller companies that offer health benefits also offer biometric screenings to employees.
• 11% of these large employers require the screening to be completed in order to enroll in the health plan, and 11% reward employees for participation or even for reaching certain health outcomes.

Although many of the findings in this survey were very similar to the findings from the previous year, more changes are expected during the next few years as more provisions of the Affordable Care Act go into effect.  The availability of the Exchanges may have an impact on employer coverage as well.  We are looking forward to seeing the results of the coming years’ surveys and will share the results with you.